Traumatic subarachnoid hemorrhage (tSAH)
Traumatic subarachnoid hemorrhage (SAH) is the pathologic presence of blood within the subarachnoid spaces, typically the superficial sulci along the cerebral convexities 1) 2).
Epidemiology
Classification
Pathology
Diagnosis
Differential diagnosis
Helpful features in suggesting that subarachnoid hemorrhage is the result of trauma, rather than the reason for trauma. These features include:
documented (witnessed) trauma not being preceded by a headache or loss of consciousness or seizure
subarachnoid blood being relatively minor and associated with cerebral contusions
subarachnoid blood located over the convexity of the brain rather than around the circle of Willis or posterior fossa
location of subarachnoid blood deep to scalp hematoma or in a contrecoup distribution
Patients with traumatic SAH have increased leukocyte counts on hospital admission, which is an important parameter of severity of injury and an additional marker of neurological outcome in patients with severe head trauma 3).
Neutrophil to lymphocyte ratio (NLR) and Platelet-to-lymphocyte ratio results (PLR) and eosinophil count values could be predictive for etiological factors (traumatic SAH or spontaneous SAH) of patients who were admitted unconscious to the emergency room with SAH detected on radiological imaging 4).
see Neutrophil to lymphocyte ratio for subarachnoid hemorrhage.